Individual
MRS. MARIYA ROSE OSTERMILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPAS, PA-C
Contact information
Practice address
2535 E FAIRVIEW AVE, MERIDIAN, ID 83642-8072
(208) 519-4333
(208) 205-9134
Mailing address
2535 E FAIRVIEW AVE, MERIDIAN, ID 83642-8072
(208) 519-4333
(208) 205-9134
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 683
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407047202
NPI
ID
Enumeration date
08/06/2007
Last updated
01/05/2024
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